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Riddell adds CDC/USA Football concussion tags

CHICAGO, May 24, 2012 -- Riddell Sports and USA Football today announced a renewed commitment to educating athletes and parents about concussion awareness. Starting today every new Riddell football helmet shipped to retailers and customers will include a hangtag offering concussion education that includes information from the Centers for Disease Control and Prevention (CDC) Heads Up program. Riddell's concussion education hangtag is the first of its kind among sports helmet manufacturers. "We have a longstanding commitment to player protection and continue to look for new ways to educate athletes and parents. As the leading manufacturer of football helmets, Riddell has raised concussion awareness through on-helmet labels and informational hangtags for over a decade," said Dan Arment, President of Riddell. "The new hangtag contains valuable information from the CDC and is the latest example of how Riddell will address concussion awareness with athletes and parents." Approximately three million American children age 6-14 play organized tackle football, placing it among the country's most popular youth sports. Since May 2009, 35 states and the District of Columbia have passed legislation to strengthen concussion education across youth and high school sports. Riddell's new hangtag will be attached to each helmet through an ear hole. The tag is titled "Raise Your Concussion Awareness" and lists concussion signs and symptoms, including CDC guidelines on what to do if a concussion is suspected. "Riddell shares USA Football's commitment to player safety and concussion awareness," USA Football Executive Director Scott Hallenbeck said. "Every parent who has a child playing youth football should ask their league two questions: 'How are your coaches trained to teach my child?' and 'Are your coaches educated on the symptoms and management of concussion?' Helmet hangtags will make certain that Riddell customers have a baseline of knowledge in this area and are directed on where they can learn more online." Riddell is the official football helmet and protective equipment partner of USA Football, the sport's national governing body in the United States. USA Football has partnered with the CDC to advance concussion education since 2007, particularly in high school and youth football. About USA Football: USA Football, the sport's national governing body in the United States, hosts more than 100 football training events annually offering education for coaches, skill development for players and resources for youth football league commissioners. The independent non-profit is the official youth football development partner of the NFL, its players and each of the league's 32 teams. Indianapolis-based USA Football manages U.S. national teams within the sport for international competition and provides $1 million annually in equipment grants and subsidizes youth league volunteer background checks. Endowed by the NFL and NFL Players Association in 2002 through the NFL Youth Football Fund, USA Football is chaired by former NFL team executive Carl Peterson. About Riddell: Founded in 1929, Riddell is a premier designer and developer of protective sports equipment and a recognized leader in helmet technology and innovation. One of Easton-Bell Sports, Inc.'s most well-known brands and the Official Helmet of the NFL®, Riddell is the leading manufacturer of football helmets, shoulder pads and reconditioning services (cleaning, repairing, repainting and recertifying existing equipment). SOURCE: Riddell Questions/comments? Contact Jean Rickerson at jean@SportsConcussions.org

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The Dynavision D2 ™

The Dynavision D2 ™ is an FDA cleared medical device with a long history concerning sports performance enhancement and an even longer history concerning neuro visual rehabilitation of stroke and brain injured patients. Physical medicine rehabilitation practitioners have used it to train brain injured patients to improve hand eye coordination since the 1980s. With a pedigree from the neuroscience community concerning rehab and from the sports community for improving performance it was a logical fit that the D2 ™ be applied to the management of the athlete with a concussion. The Dynavision D2 ™ is a light board with 64 lights mounted in a board along with a small screen. The primary task is to hit the red or green lights. It assesses speed and coordination. When the computer screen and lights are used together there are numerous tasks the athlete can be asked to do. Several universities and professional sports organizations have adopted the Dynavision D2 ™ as part of the concussion management program, and for good reason. The Dynavision D2 ™ can be used as part of baseline testing. The results of the baseline tests are used for comparisons should a concussion occur. These same athletes may also train their eye hand coordination using the Dynavision D2 ™ for performance enhancement. This means the device is familiar to them and true baseline and performance parameters can be obtained. After a concussion, the Dynavision D2 ™ can be used as part of a traditional neuro cognitive examination and monitoring program. The baseline Dynavision D2 ™ results can be compared to repeat tests to see if deficits are present. Further, programs designed to assess multiple brain cognitive parameters can be performed in just a few minutes. The three tests assess: eye-hand coordination while multi-tasking, memory and cognition, cognition and executive functions. Observing the subject and noting their scores allows for an assessment of their concussion status. One of the strengths of the Dynavision D2 ™ is that it has an established cadre of programs that anyone can use. These programs can be used for rehab, prehab and diagnostics. Plus it has a relatively intuitive program option that allows more experienced practitioners and ADT trained individuals to design their own programs to meet their needs. This means that the Dynavision is a highly flexible and adaptable platform. Every person who works with athletes, injured athletes and neuro patients knows that each person is different and unique; training and rehab methods need to be personalized. Fortunately the Dynavision allows us to customize the programs to address the needs of the patient. There are numerous anecdotes where a patient who expresses a deficit that he/she is having to a rehab person who can write and try a program to help that patient during that very rehab session. One of my patients at the concussion clinic in theUniversityofCincinnatiwas injured in a wind storm. During her baseline neuro exam, we utilized the tests mentioned above and additional tests based on her specific results. The D2 was able to demonstrate the patient was unable to multi-task, making numerous math errors on simple 1 digit additions. In addition, based on a general neuro exam, the patient exhibited deficiencies in ocular motor, memory and executive function. This patient specifically benefited from the D2 as part of her neuro exam because the D2 gave measurable, unbiased results. The results of the exam were utilized to incorporate D2 training into her rehab program to improve binocularity, reaction time, multi-tasking, and cognition skills. In my opinion, without using the D2, this patient’s rehab would not have been as successful and it could have been possible to overlook subtle deficiencies that D2’s measurable results are able to track. In the center of the Dynavision D2 ™ is a tachistoscope; or small computer screen. This screen is used in several of the evaluation and rehabilitation methods. It adds tremendous flexibility to the system because it can be used to add tasks to what the subject is required to do. With the tachistoscope the patient can now be required to do a hand-eye task as well as reading or other task from the screen. This allows for multitasking to be performed and adds to the flexibility and strength of the Dynavision D2 ™ as a tool to manage the concussion patient. Repeating the evaluations on the Dynavision D2 ™ can be used as part of quantitative monitoring of the subjects as they progress through concussion rehab. The Dynavision produces reliable numbers that reflect the subjects’ performance or highlights deficiencies. When the Dynavision D2 ™ is used as part of the rehab training it becomes a cornerstone in the patient’s care and the patient can see, based on their own results, how well they are doing. Rehabilitation methods can be tailored to the needs of the patient and with many years of experience from the stroke and brain injury literature there are numerous options for the Dynavision D2 ™ to aid in a concussion rehabilitation program. About the Authors: Dr. Clark is a certified athletic trainer, professor of neurology and member of the concussion management team in the University of Cincinnati. He is an expert in complications post acquired brain injury and has published several texts and over 100 scientific articles. Mrs. Umberg is a former concussion patient and the patient referred to in this Case Study. Having used Dynavision as part of her rehab program she has since become a patient advocate and team member in the concussion management team in the University of Cincinnati and Dynavision Trainer. Disclaimer; the statements made are not screened or approved by the FDA. Source: Joseph F. Clark and Jennifer A. Umberg Department of Neurology, University of Cincinnati, Cincinnati Ohio; 45267-0536. Corresponding author: Joseph F. Clark, Professor of Neurology, joseph.clark@uc.edu.

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Video games used to assess concussions

COLUMBUS, Ohio – There is no magic test to determine when an athlete is ready to get back into the game after they have suffered a head injury. Researchers have started using an interactive video game, a tool many athletes are already using in rehabilitation, to test balance for concussion assessment and management. The reliability of the video game for assessing athletes’ concussions has not been confirmed, but a study by a sports medicine researcher from The Ohio State University Wexner Medical Center may provide insight to the use of the Nintendo’s Wii Fit for concussion management. Team athletic trainers often determine whether an athlete has a concussion based on their physical examination, cognitive ability, self-report of symptoms and balance. "Student athletes love it because we have incorporated fun into their rehabilitation and concussion assessment," said Tamerah Hunt, director of research at the OSU’s Sports Medicine Concussion Program. “For many school districts, it is an affordable option and can be portable, making it convenient for sideline testing and travel with the team for away games.” Researchers from Ohio State and the University of Maryland are conducting baseline testing for concussion management in collegiate athletes, and will soon do the same among high-school athletes. Recent concussion guidelines suggest postural control is an important part of the assessment process, which makes balance an important piece of information in determining recovery from a head injury. “It’s not the perfect system, but can be considered as an option to provide basic objective information about balance,” said Hunt, whose previous research includes examining concussion recovery patterns among high school students in several states. “It’s another tool to have in our toolkit because determining when an athlete has recovered can be subjective,” Hunt admits. “Athletes are more likely to engage with a video game than to take another boring concussion test or admit they are still hurt,” said Hunt. “We currently base much of our assessment on an athlete telling us about their symptoms. The video game allows us to broadly analyze center of gravity, to help us be more objective.” Athletes participate in three different yoga poses as demonstrated on the Wii Fit game and are given a score which determines how well the athlete maintained center of balance. Baseline testing provides athletic trainers with an idea of how an athlete normally functions. If an athlete suffers a head injury at a later date, the athletic trainer can assess the balance of the athlete compared to their normal ability. According to Hunt, an athletic trainer must obtain the baseline measures to compare the athlete to themselves because everyone performs differently. Preliminary data suggests a moderate correlation to current methods used in concussion assessment, ranging from 0.75-0.82, depending on the stance. “Additional studies need to be performed to determine the long-term reliability of the measures and other factors associated with test scores, such as fatigue,” said Hunt. This is just the beginning of studies using alternative measures of balance assessment like the Wii Fit for concussion management. The National Collegiate Athletic Association concussion guidelines support using the video game as a postural assessment tool. It is not yet approved as a medical device by the Food and Drug Administration. Source: Ohio State University Wexner Medical Center -- May 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

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Brain wiring a no-brainer? (video)

The brain appears to be wired more like the checkerboard streets of New York City than the curvy lanes of Columbia, Md., suggests a new brain imaging study. The most detailed images, to date, reveal a pervasive 3D grid structure with no diagonals, say scientists funded by the National Institutes of Health. “Far from being just a tangle of wires, the brain’s connections turn out to be more like ribbon cables -- folding 2D sheets of parallel neuronal fibers that cross paths at right angles, like the warp and weft of a fabric,” explained Van Wedeen, M.D., of Massachusetts General Hospital (MGH), A.A. Martinos Center for Biomedical Imaging and the Harvard Medical School. “This grid structure is continuous and consistent at all scales and across humans and other primate species." Wedeen and colleagues report new evidence of the brain’s elegant simplicity March 30, 2012 in the journal Science. The study was funded, in part, by the NIH’s National Institute of Mental Health (NIMH), the Human Connectome Project of the NIH Blueprint for Neuroscience Research, and other NIH components. “Getting a high resolution wiring diagram of our brains is a landmark in human neuroanatomy,” said NIMH Director Thomas R. Insel, M.D. “This new technology may reveal individual differences in brain connections that could aid diagnosis and treatment of brain disorders.” Knowledge gained from the study helped shape design specifications for the most powerful brain scanner of its kind, which was installed at MGH’s Martinos Center last fall. The new Connectom diffusion magnetic resonance imaging (MRI) scanner can visualize the networks of crisscrossing fibers – by which different parts of the brain communicate with each other – in 10-fold higher detail than conventional scanners, said Wedeen. “This one-of-a-kind instrument is bringing into sharper focus an astonishingly simple architecture that makes sense in light of how the brain grows,” he explained. “The wiring of the mature brain appears to mirror three primal pathways established in embryonic development.” As the brain gets wired up in early development, its connections form along perpendicular pathways, running horizontally, vertically and transversely. This grid structure appears to guide connectivity like lane markers on a highway, which would limit options for growing nerve fibers to change direction during development. If they can turn in just four directions: left, right, up or down, this may enforce a more efficient, orderly way for the fibers to find their proper connections – and for the structure to adapt through evolution, suggest the researchers. Obtaining detailed images of these pathways in human brain has long eluded researchers, in part, because the human cortex, or outer mantle, develops many folds, nooks and crannies that obscure the structure of its connections. Although studies using chemical tracers in neural tracts of animal brains yielded hints of a grid structure, such invasive techniques could not be used in humans. Wedeen’s team is part of a Human Connectome Project Harvard/MGH-UCLA consortiumExternal Link: Please review our disclaimer. that is optimizing MRI technology to more accurately to image the pathways. In diffusion imaging, the scanner detects movement of water inside the fibers to reveal their locations. A high resolution technique called diffusion spectrum imaging (DSI) makes it possible to see the different orientations of multiple fibers that cross at a single location – the key to seeing the grid structure. In the current study, researchers performed DSI scans on postmortem brains of four types of monkeys – rhesus, owl, marmoset and galago – and in living humans. They saw the same 2D sheet structure containing parallel fibers crossing paths everywhere in all of the brains – even in local path neighborhoods. The grid structure of cortex pathways was continuous with those of lower brain structures, including memory and emotion centers. The more complex human and rhesus brains showed more differentiation between pathways than simpler species. Among immediate implications, the findings suggest a simplifying framework for understanding the brain’s structure, pathways and connectivity. The technology used in the current study was able to see only about 25 percent of the grid structure in human brain. It was only apparent in large central circuitry, not in outlying areas where the folding obscures it. But lessons learned were incorporated into the design of the newly installed Connectom scanner, which can see 75 percent of it, according to Wedeen. Much as a telescope with a larger mirror or lens provides a clearer image, the new scanner markedly boosts resolving power by magnifying magnetic fields with magnetically stronger copper coils, called gradients. Gradients make it possible to vary the magnetic field and get a precise fix on locations in the brain. The Connectom scanner’s gradients are seven times stronger than those of conventional scanners. Scans that would have previously taken hours – and, thus would have been impractical with living human subjects – can now be performed in minutes. “Before, we had just driving directions. Now, we have a map showing how all the highways and byways are interconnected,” said Wedeen. “Brain wiring is not like the wiring in your basement, where it just needs to connect the right endpoints. Rather, the grid is the language of the brain and wiring and re-wiring work by modifying it.” Curvature in this DSI image of a whole human brain turns out to be folding of 2D sheets of parallel neuronal fibers that cross paths at right angles. This picture came from the new Connectom scanner.Source: Van Wedeen, M.D., Martinos Center and Dept. of Radiology, Massachusetts General Hospital and Harvard University Medical School Reference Wedeen VJ, Rosene DL, Ruopeng W, Guangping D, Mortazavi F, Hagmann P, Kass JH, Tseng W-YI. The Geometric Structure of the Brain Fiber Pathways: A Continuous Orthogonal Grid. March 30, 2012 Science. ### The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website. The NIH Blueprint for Neuroscience Research is a cooperative effort among the NIH Office of the Director and the 15 NIH Institutes and Centers that support research on the nervous system. By pooling resources and expertise, the Blueprint supports transformative neuroscience research, and the development of new tools, training opportunities, and other resources to assist neuroscientists. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

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Girls' lacrosse; a referee's view

As a new womens' lacrosse referee I initially had mixed feelings about the ongoing debate on the use of helmets in play. Listening to the discussion in referee training sessions that stressed the finesse of the game and the need of the referee to control or slow down play, verses the struggle I felt as a person having a medical degree and realizing the potential hazards of brain injuries, I tried to see both sides. Some people think that helmets will make the game more physical. But after my first official day as a referee standing on the sidelines watching my daughter’s middle school team begin their game, my beliefs became clear. Female lacrosse players need to wear helmets. During the first eight minutes of the game there were three injuries, one related to a child’s head and neck. This player had been checked from behind causing her neck to snap back. She then fell and hit her head on the turf. I witnessed every parent’s/referee’s/coach’s nightmare: a player down and seizing. To my dismay, this player returned to play in less than three weeks and went on to have another concussion and seizure. She is now barred from impact sports for the rest of her life. What I found out about my local school district surprised me and motivated me to try to educate parents and give people the best information possible. After speaking to the athletic trainers in my school district, I was made aware that high school students are given baseline concussion testing but younger players are not. We are now in the process of offering that testing to younger players. Also, while coaches can have in-person or online concussion training it seems that more could be done to help the coaches and parents become more informed about concussions. There are numerous issues that could explain the high incidence of concussions in women's lacrosse. One might be to consider the nutrition and health of girls playing the game today. Both men and women today are better nourished and physically stronger, faster and more powerful than the players of previous years. This has created a weight imbalance as some players can actually outweigh others by a large margin. The physics of combining speed and extra mass can lead to a dangerous combination. Equipment has also evolved to allow for lighter and faster sticks, causing unintended hits in some instances, I'm sure. Another factor is the increase in new players due to the popularity of the sport. Putting players of different skill levels in the same game can set up a difficult dynamic. It is important for players to be aware of their body position in space and reference to other players. This is a skill that comes with time and coaching. Coaching is another aspect of the game that helps teams work together better and control the speed of their game. Neck strengthening exercises can decrease the whiplash motion often caused by a hit to the cranial region. As for me, I have now completed my first season as a referee. I feel that helmets and proper body equipment in womens' lacrosse will make the game safer for everyone. My feeling is that there are too many factors that increase the potential for head injuries and we should mitigate them as best we can. While I realize helmets do not prevent concussions, I do believe they would be helpful to protect young women from unintended hits to the head. Dr. Lori McGowan is an Adjunct Professor of Biology at Harrisburg Area Community College in Harrisburg, Pennsylvania.

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First soccer head impact study

Collisions. Headers. Goalpost run-ins. Soccer athletes and fans can't help but wonder which elements contribute most to the frequency of concussions in the sport, particularly among young girls. Researchers have been collecting data in helmeted sports for many years using accelerometers embedded in head gear, but non-helmeted sports have presented obvious challenges. Impact data has provided some of the most critical science in the concussion field. As a result, the forces that players sustain in various contact sports are well-documented and found, in some cases, to be alarming. The latest addition to the data bank was the inclusion of an impact study on 7-and 8-year-old football players and the adult-sized forces they incurred during practices. Now the focus is turning to other sports, including soccer. A new study by researchers at Wayne State University, published in the Journal of the American College of Sports Medicine offers insight into head acceleration in girls' youth soccer (U14) during game play. HITS The Head Impact Telemetry System (HITS) used to measure the force impacts, was utilized in this study. Small accelerometers typically mounted inside helmets, transmit data wirelessly to researchers on the sideline. In this case, soccer headbands with the padding removed were outfitted with the instrumentation. Impacts over 10g, or 10x the force of gravity, were recorded and analyzed at a later time alongside corresponding video footage to determine the nature of the hit. For reference, a sneeze might be 3g, a fighter pilot might "pull" 9g during maneuvers, and high school football players regularly sustain hits ranging from 60-100g and higher, many without reporting concussion symptoms. A total of 24 girls participated in the study, conducted during scrimmages on grass fields. Scrimmages lasted 30 to 65 minutes each. None of the players suffered a concussion during the research. Results There were 47 header impacts and 20 non-header impacts observed during the study. Non-header impacts included collisions with another player, player falls, collisions with goalposts, and unintended collisions with the ball. Researchers found: - majority of non-header impacts (40%) were player-to-player collisions - most headers impacted the front of the head; the peak linear acceleration (force) recorded was 4.5g- greatest header force occurred on the right side of the head and was measured at 62.9g - most head impacts players sustained in one scrimmage was four - side headers resulted in greater forces than back headers - player collisions resulted in the highest number of nonheader impacts and had a maximum force of 56.7g - impacts from player falls measured a maximum force of 23.7g - a goalpost collision measured a maximum of 27.1g Researchers hypothesized that non-header impacts would exceed those from heading the ball, but that was not what the case. Many of the players experienced multiple impacts in a single scrimmage, the cumulative effects of such impacts within a short time frame are unknown. Conclusions Concussions can occur in any sport and amending equipment and making rule changes to decrease the frequency and severity of the injury depends on science. Soccer has emerged as the leading cause of sport-related concussions for young girls and researchers are working to unravel the reasons why. Hypotheses range from less neck strength, to hormonal differences to better reporting by females. Source: Medicine & Science in Sports & Exercise: June 2012 - Volume 44 - Issue 6 - p 1102–1108 doi: 10.1249/MSS.0b013e3182444d7d Applied Sciences Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

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Progesterone seems to protect neurons after injury

It is not yet known why girls suffer concussions at a higher rate than boys. The most prevalent theories range from lesser neck and upper body strength, to better reporting among females, to hormonal differences. Researchers at Emory University in Atlanta are currently in the third phase of a clinical trial designed to determine if the hormone progesterone, normally associated with female reproductive processes, can protect damaged neurons. Administered within four hours of the injury and lasting for three days, results of the treatment have been positive so far. Although catastrophic injuries in sports are rare, the question regarding applicability of a related treatment for concussion remains open. Pilot study highlighted efficacy Every 15 seconds, someone in the United States sustains a significant traumatic brain injury. Approximately 2 million adults and children in the United States suffer from traumatic brain injuries each year - leading to 50,000 deaths and 80,000 new cases of long-term disability, according to the Centers for Disease Control and Prevention. Despite the enormity of the problem, scientists have failed to identify effective medications to improve outcomes following a traumatic brain injury. Emory researchers, however, concluded in an earlier pilot clinical trial that giving progesterone to trauma victims shortly following brain injury appears to be safe and may reduce the risk of death and long-term disability. Their previous three-year study, called ProTECT I (Progesterone for Traumatic brain injury--Experimental Clinical Treatment), enrolled 100 participants at Grady Memorial Hospital. It was designed to evaluate whether progesterone can be administered intravenously in a safe and reliable way. "We found evidence that progesterone is not only safe for use in patients suffering from traumatic brain injuries," says Wright. "We also found a 50 percent reduction in mortality in those patients treated with progesterone. Even though this was a small pilot study, we found signs that progesterone improved functional outcomes and reduced disability in patients with moderate brain injury. "By expanding our test sites to 17 major trauma centers across 15 states and enrolling more than 1,000 patients, we hope to confirm these preliminary findings and determine if progesterone benefits victims of acute traumatic brain injury," says Wright. Progesterone common in males and females Progesterone is naturally present in small but measurable amounts in the brains of males and females. Human brain tissue is loaded with progesterone receptors. Laboratory studies suggest that progesterone is critical for the normal development of neurons in the brain and exerts protective effects on damaged brain tissue. Donald G. Stein, PhD, Asa G. Candler Professor of Emergency Medicine, Emory School of Medicine, and director of Emory's Department of Emergency Medicine Brain Research Laboratory, pioneered discoveries regarding the effect of progesterone following traumatic brain injury - first discovering the neuro-protective properties of progesterone in the laboratory more than 25 years ago. "The results that we are now seeing, and hope to continue validating, are an incredible and gratifying reward for more than 25 years of concentrated research," says Stein. "My work first started when I began to notice evidence that women tended to respond to treatment and recover better than men after suffering from brain injury and stroke. Many people do not realize that it's not just a female hormone; both men and women produce progesterone directly in the brain, as well as other tissue. "Ultimately, we learned that progesterone basically does in brain injuries what it also does during fetal development - protect cells and tissue," says Stein. "To now witness the translation of this laboratory research into a treatment that may have life-saving benefits is breathtaking." Source: A Hormonal Remedy for Brain Injuries is Explored --The New York Times -- June 21, 2012 Atlanta To Serve as National Epicenter for Promising Phase III Brain Injury Treatment Trial - Emory University Photo courtesy of (c) 2008 Eddy Grady@creativecommons.com Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

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SportsConcussions.org receives All-Star Award

SportsConcussions.org Named One of Constant Contact’s 2011 All Stars SportsConcussions.org recognized for achieving exemplary marketing results SEQUIM, Wash. — April 4, 2012 – SportsConcussions.org, a non-profit concussion education organization, has received the 2011 All Star Award from Constant Contact®, Inc., the trusted marketing advisor to more than half a million small organizations worldwide. Each year, a select group of Constant Contact customers are honored with the All Star Award for their exemplary marketing results. SportsConcussions.org’s results ranked among the top 10% of Constant Contact’s customer base. “We’re pleased to be recognized by Constant Contact for achieving strong marketing results, said Jean Rickerson, CEO and Founder of SportsConcussions.org. “Constant Contact’s tools have helped us reach a large audience with the all-important message regarding sports-related concussions in a very efficient way. We look forward to increasing our communication efforts even more in the coming year, to help protect more athletes. We are very grateful to all of our customers who follow us on our website, on social media and through our weekly newsletter. Our goal is to provide them with ideas and resources so they can protect athletes in their local communities.” Constant Contact looked at the following criteria to select this year’s All Stars: · Frequency of campaigns, events, and surveys · Open, bounce, and click-through rates · Event registration rates · Survey completion rates · Use of social features · Use of mailing list sign-up tools “There is nothing we like more than to see our customers finding success. It’s the reason Constant Contact was founded, and it’s a thrill to see the fantastic results that our All Stars are achieving,” said Gail Goodman, CEO of Constant Contact. “This group is really leading the charge when it comes to delivering relevant, engaging content that drives real business results. We salute this year’s All Stars for their success, and are honored to have played a part in their achievements.” About SportsConcussions.orgSportsConcussions.org is a non-profit organization dedicated to raising awareness about sports-related concussions. According to the Centers for Disease Control and Prevention (CDC) up to 3.8 million people suffer from a recreation- or –sport related concussion each year. SportsConcussions.org is anchored by a website that is update daily, featuring news, ideas and resources for school districts, leagues, coaches, parents and athletes. The organization also holds community workshops and conferences, and establishes baseline testing programs. About Constant Contact, Inc. Constant Contact is revolutionizing the success formula for small organizations through affordable, easy-to-use Engagement MarketingTM tools that help create and grow customer relationships. More than half a million small businesses, nonprofits, and associations worldwide rely on Constant Contact to drive ongoing customer dialogs through email marketing, social media marketing, event marketing, and online surveys. All Constant Contact products come with unrivaled KnowHow, education, and free coaching with a personal touch, including award-winning customer support.

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"Head Games" previews May 15

The first of three private screenings was held in Chicago on May 15th for "Head Games," a documentary on the sports concussion crisis. From acclaimed director Steve James (Hoop Dreams, The Interrupters) and award-winning producer Bruce Sheridan, Head Games takes a deeper look at the devastating and long-term effects of concussions in all sports. Inspired by events from the book Head Games written by Christopher Nowinski, the film offers eye-opening insight and cutting-edge science on head trauma from the nation’s leading medical experts. Additional screenings will be held June 6 at the Boston University School of Medicine Albany Street Auditorium and June 7 in Philadelphia at the Translational Research Center (TRC) Rubenstein Auditorium. Watch the trailer Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

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Jean Rickerson

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Friday, 01 February 2013 13:49

SportsConcussions.org reaches USA Today's Super Bowl audience

SportsConcussions.org is proud to bring the concussion message to USA Today's 2013 Super Bowl audience. Our full-page ad appears in the USA Today Sports Special Edition "Super Bowl preview" available for purchase on newsstands through Feb. 4th. The 63-page publication includes scouting reports, predictions, reviews and interesting Super Bowl stories from the nation's leading sportswriters. Pick up your copy today!

Top photo courtesy: Mike Dashiell, Sequim Gazette

Published in Featured Articles K2

Tuesday, 29 January 2013 12:44

President Obama Adds Fuel to Concussion Debate

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President Obama's recent remarks regarding concussions in football reopened the discussion of the safety of the game just days before Super Bowl Sunday.

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In an interview appearing in the New Republic Obama says, "If I https://on, I'd think long and hard before I let him play football. And I think that those of us who love sports are going to have to wrestle with the fact that it will probably change gradually to try to reduce some of the violence."

Leaders from sports-related organizations including pee-wee, high school, college and professional have worked for several years now to understand the injury, provide guidance to athletes and coaches, and fund research related to the effects of brain trauma. Changes have been broad and deep.

NFL Commissioner Roger Goodell has surrounded himself with the most well-respected medical professionals in the concussion field, seeking their council. As co-chairmen of the NFL Head, Neck and Spine Committee, Drs. Richard Ellenbogen (chief of neurosurgery, Univ. of Washington) and Hunt Batjer (President of the Neurological Society of America) have assembled an impressive team, including senior adviser Dr. Robert Cantu, co-director Center for the Study of Traumatic Encephalopathy. Chronic traumatic encephalopathy, or CTE, is a degenerative brain disorder suspected to be associated with repetitive hits to the head. Previously only diagnosed post-mortem, evidence of the disease was recently found in five former NFL players who took part in a recent groundbreaking diagnostic study at UCLA.

The committee is also actively involved in improving on-field recognition and assessment policies, helmet technology, and brain impact research. In 2011, the NFL dedicated over $100 million over the next decade to medical research, with the vast majority of those dollars committed to the science of concussions, their prevention and care.

Concussions have always been a part of sports, and have never been limited to football. Soccer, volleyball, wrestling, lacrosse, bicycling, and yes, playground activities can all cause concussive injuries. Girls are at risk as much as boys. Seniors and soldiers suffer too.

Change of this magnitude takes time. Those athletes who have paid the price through their individual suffering are heroes, having opened the door for the rest of us, exposing an issue whose time is due. Former NFL linebacker Junior Seau, who tragically took his own life in 2012 at age 43, was later diagnosed with CTE, which many believe contributed to his death. He and the other NFL, NHL and professional boxers who died at a young age and were later diagnosed with CTE, have commanded our attention.

In 2006, Zachery Lystedt suffered a debilitating brain injury during a middle school football game at age 14, and now fights daily to escape his wheelchair. Zachery, with the help of Commissioner Goodell and the NFL, inspired and helped develop legislation in almost every state helping to safeguard youth athletes from the effects of concussions. Zach's hero, Baltimore Ravens Ray Lewis will play in Sunday's Super Bowl. Zach and the estimated 111 million viewers will watch a safer game, one that is still evolving, striving to maintain the integrity of the contest while preserving the health of its players for the future.

Thankfully, visionaries like Commissioner Goodell appear in the right place at the right time. Under his leadership the NFL has, and is, providing a road map and the necessary funding to investigate the questions and find solutions that will improve our understanding of risk as it applies to protecting our youth, preserving the competitive spirit, and honoring the bonds that bind us as teammates and fans.

Photo courtesy: Creative Commons; copyright dcJohn 2004

Published in Featured Articles K2

Tuesday, 12 June 2012 00:00

Pop Warner limits contact practices

Pop Warner, the nation's largest youth football organization announced Tuesday it is taking steps to eliminate hits to the head and reduce the number of concussions suffered by players.

Chairman of the Pop Warner medical advisory board, Dr. Julian Bailes said, "The impact of head-to-head contact causes the most severe concussions, so we felt it was imperative that Pop Warner take a proactive approach and limit contact in practices. We're trying to take away all at once the head-to-head contact in practice."

Pop Warner is the nation's oldest and largest youth football, cheerleading and dance program, with over 400,000 members ranging in age from 5-14.

Starting in August many teams practice nine hours a week until Labor Day when most are then shortened https://hours. Research has shown that some of the hardest hits and many concussions occur during practice, not games. New rules prohibit head-to-head hits and limit contact in practices to 40 minutes a day. Fulhttps:// head-on blocking and tackling drills where players line up more than three feet apart are no longer allowed.

In April 2012, veteran journalist and former Dateline co-anchor, Stone Phillips produced a report entitled, "Hard Hits, Hard Numbers," detailing a Virginia Tech study on head impacts in youth football. Accelerometers placed inside 7- and 8-year-old players' helmets recorded hits from 15g-100g, surprising researchers. Previously, many believed that players that age did not have the speed or strength to deliver hits of those magnitudes.

Over 4 million sports- and recreation-related concussions occur each year in the United States and more than half of those are suffered as a result of football, reported NBC News.

Source: Pop Warner limits contact in practice -- Boston.com -- June 12,2012

Pop Warner issues new safety regulations -- NBC News --June 12, 2012

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Friday, 08 June 2012 10:15

Why concussions affect people differently

https://https:// https://https://

June 8, 2012 — (Bronx, NY) — Patients vary widely in their response to concussion, but scientists haven’t understood why. Now, using a new technique for analyzing data from brain imaging studies, researchers at Albert Einstein College of Medicine of Yeshiva University andMontefiore Medical Center have fhttps://at concussion victims have unique spatial patterns of brain abnormalithttps://t change over time.

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The new technique could eventually help in assessing concussion patients, predicting which head injuriehttps://ikely to have long-lasting neurological consequences, and evaluating the effectiveness of treatments, according to lead author Michael L. Lipton, M.D., Ph.D., associate director of the Gruss Magnetic Resonance Research Center at Einstein and medical director of magnetic resonance imaging (MRI) services at Montefiore. The findings are published today in the online edition of Brain Imaging and Behavior.

The Centers for Disease Control and Prevention estimates that more than one million Americans sustain a concussion (also known as mild traumatic brain injury, or mTBI) each year. Concussions in adults result mainly from motor vehicle accidents or falls. At least 300,000 adults and children are affected by sports-related concussions each year. While most people recover from concussions with no lasting ill effects, as many as 30 percent suffer permanent impairment – undergoing a personality change or being unable to plan an event. A 2003 federal study called concussions “a serious public health problem” that costs the U.S. an estimated $80 billion a year.

Previous imaging studies found differences between the brains of people who have suffered concussions and normal individuals. But those studies couldn’t assess whether concuhttps://ictims differ from one another. “In fact, most researchers have assumed that all people with concussions have abnormalities in the same brain regions,” said Dr. Lipton, who is also associate professor of radiology, ofpsychiatry and behavioral sciences, and in the Dominick P. Purpura Department of Neuroscience at Einstein. “But that doesn’t make sense, since it is more likely that different areas would be affected in each person because of differences in anatomy, vulnerability to injury and mechanism of injury.”

In the current study, the Einstein researchers used a recently developed MRI technique called diffusion tensor imaging (DTI) on 34 consecutive patients (19 women and 15 men aged 19 to 64) diagnosed with mTBI at Montefiore in the Bronx and on 30 healthy controls. The patients were imaged within two weeks of injury and again three and six months afterward.

The imaging data were then analyzed using a new software tool called Enhanced Z-score Microstructural Assessment Pathology (EZ-MAP), which allows researchers for the first time to examine microstructural abnormalities across the entire brain of individual patients. EZ-MAP was developed by Dr. Lipton and his colleagues at Einstein.

DTI detects subtle damage to the brain by measuring the direction of diffusion of water in white matter. The same technology was used by Dr. Lipton and his team in widely publicized research on more than 30 amateur soccer players who had all played the sport since childhood. They found that frequent headers showed brain injury similar to that seen in patients with concussion.

The uniformity of diffusion direction – an indicator of whether tissue has maintained its microstructural integrity – is measured on a zero-to-one scale called fractional anisotropy (FA). In the latest study, areas of abnormally low FA (reflecting abnormal brain regions)https://bserved in concussion patients but not in controls. Each concussion patient had a unique spatial patthttps://low FA that evolved over the study period.

https://https://

Surprisingly, each patient also had a unique, evolving pattern of abnormally high FA distinct from the areas of low FA. “We found widespread high FA at every time point, all the way out to six months and even in patients more than one year out from their injury.” said Dr. Lipton. “We suspect that high FA represents a response to the injury. In other words, the brain may be trying to compensate for the injury by developing and enhancing other neural connections. This is a new and unexpected finding.”

At present, diagnosis of concussions is based mainly on the nature of the patient’s accident and the presence of symptoms including headache, dizziness and behavioral abnormalities. DTI, combined with EZ-MAP analysis, might offer a more objective tool for diagnosing concussion injuries and for predicting which patients will have persistent and progressive symptoms.

The paper is titled “Robust Detection of Traumatichttps:// Injury in Individual Mild Traumatic Brain Injury Patients: Intersubject Variation, Change Over Time and Bidirectional Changes in Anisotropy.” Contributors include Namhee Kim, Ph.D.; Tova M. Gardin, B.A.; Kehttps://ifteh, M.D.; Mimi Kim, Sc.D.; Molly E. Zimmerman, Ph.D.; Richard B. Lipton, M.D.; and Craig A. Branch, Ph.D., all of Einstein and Montefiore; and Young Park, M.D., who earned his degree from Einstein; and Miriam Hulkower, a medicalhttps://t at Einstein.

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The authohttps://rt no conflicts of interest.

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###

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Albert Einstein College of Medicine
Albert Einstein College of Medicine of Yeshiva University is one of the nation’s premier centers for research, medical education and clinical investigation. In 2011, Einstein received nearly $170 million in awards from the NIH for major research centers at Einstein in diabetes, cancer, liver disease, and AIDS, as well as other areas. Through its affiliation with Montefiore Medical Center, the University Hospital for Einstein, and six other hospital systems, the College of Medicine runs one of the largest post-graduate medical training programs in the United States, offering 155 residency programs to more than 2,200 physicians in training. For more information, please visit www.einstein.yu.edu and follow us on Twitter @EinsteinMed.

Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Montefiore is consistently recognized among the top hospitals nationally by U.S. News & World Report, and excels at educating tomorrow's healthcare professionals in superior clinical and humanistic care. Linked by advanced technology, Montefiore is a comprehensive and integrated health system that derives its inspiration for excellence from its patients and community. For more information, please visit www.montefiore.org andwww.montekids.org and follow us on Twitter (https://twitter.com/#!/MontefioreNews) @MontefioreNews.

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Thursday, 07 June 2012 10:24

Thousands of former players vs. NFL

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PHILADELPHIA -- Lawyers representing more than 2,000 former NFL players filed a mega-lawsuit in federal court on Thursday, consolidating at least 81 head injury-related legal complaints into one. The combined lawsuit accuses the NFL of hiding information about repetitive head trauma and the long-term effects, and that the league “deliberately and fraudulently concealed from its players the link between football-related head impacts and long-term neurological injuries,” according to The Los Angeles Times.

The 88-page complaint states that the league “was aware of the evidence and the risks associated with repetitive traumatic brain injuries virtually at its inception, but deliberately ignored and actively concealed the information from the Plaintiffs and all others who participated in organized football at all levels.”

The complaint also charges that "The NFL, like the sport of boxing, was aware of the health risks associated with repetitive blows producing sub-concussive and concussive results and the fact that some members of the NFL player population were at significant risk of developing long-term brain damage and cognitive decline as a result.''

"Despite its knowledge and controlling role in governing player conduct on and off the field, the NFL turned a blind eye to the risk and failed to warn and/or impose safety regulations governing this well-recognized health and safety problem,'' according to The AP.

"Our legal team will review today's filing that is intended to consolidate plaintiffs' existing claims into one "master'' complaint,'' the NFL said in a statement. "The NFL has long made player safety a priority and continues to do so. Any allegation that the NFL sought to mislead players has no merit. It stands in contrast to the league's many actions to better protect players and advance the science and medical understanding of the management and treatment of concussions.''

Player assistance

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The NFL provides a series of medical benefits to former NFL players to help them after football, including joint replacement, neurological evaluations and spine treatment programs, assisted living partnerships, long-term care insurance, prescription benefits, life insurance programs, and a Medicare supplement program.

One of the programs, the 88 Plan, named after Hall of Fame tight end John Mackey, has spent more than $7 million to reimburse some medical expenses of former players with dementia.

Gay Culverhouse, https://president of the Tampa Bay Buccaneers established the https://sportsillustrated.cnn.com/2012/football/nfl/wires/06/07/2020.ap.fbn.concussion.lawsuits.3rd.ld.writethru.1225/index.html#ixzz1x8516Qrw

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Sunday, 03 June 2012 11:20

Pro soccer's top doc on concussions

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Dr. Ruben Echemendia, a clinical neuropsychologist who chairs Major League Soccer's Concussion Protocol Committee says the number of concussions in the league have increased slightly, but attributes that to team expansion from 16 to 18 and heightened awareness, according to The Denver Post.

Dr. Dawn Comstock, an epidemiologist at Nationwide Children's Hospital in Ohio stated last year that researchers would likely see a spike in the number of concussions as the public became more aware of the signs and symptoms. "Dings" and "bell ringers" would be recognized as injuries to the brain and properly reported, diagnosed and managed.

Echemendia, a former president of the National Academy of Neuropsychology is also the director of the NHL's concussion working group formed in 1977. He reported a slight increase in concussions in the NHL over previous years.

Returning, retiring

His stance on returning a player to any activity is constant, regardless of the sport. "The real key is to make sure we identify this injury, we identify it quickly and get players off the field. And that we then manage them appropriately before putting them back out there," Echemendia said.

The decision to retire is complicated.

"If a player is coming to me and all of a sudden we're seeing that he tends to have concussions more readily — that is, the concussions are now coming about with lesser and lesser blows, the symptoms are more severe both cognitively and physically, and they tend to last longer than they have in the past, then we begin to wonder about retirement," Echemendia said. "Part of that has to weigh in a risk-benefit analysis for the player — where they are in their lives, what are they doing, what kinds of risks do they want to take," according to The Denver Post.

MLS concussion protocol

Under Echemendia's guidance, the current MLS concussion protocol includes neuropsychological baseline testing and:

• Any player suspected of having suffered a concussion will be removed from play immediately and evaluated by the team's medical staff. If the initial evaluation results in a concussion diagnosis, he will not be returned to play in the same game or practice.

• Every MLS club has a designated Team Consulting Neuropsychologist, one of whom will conduct the post-concussion evaluation when an injured player is symptom-free at rest, prior to his return to contact play or practice.

• Any player diagnosed with a concussion will be free of somatic and cognitive symptoms for at least 24 hours before starting an individualized, graded return-to-play progression under the supervision of the team physician.

• Once a player ihttps://om-free at rest and deemed to be neurocognitively at or above his baseline, he can begin light aerobic workouts, followed by more intense workouts. A player should only progress to the next step if he remains symptomhttps:///p>https://

• The team physician has the ultimate authority to decide when a player returns.

Source: Rapids feeling effects of head hits as concussions get more MLS scrutiny - The Denver Post https://www.denverpost.com/sports/ci_20770179/concussions-colorado-rapids-effects-mls-scrutiny?source=pkg#ixzz1wlHodZIO

Questions/comments? contact Jean Rickerson at This email address is being protected from spambots. You need JavaScript enabled to view it.

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Read more:Rapids feeling effects of head hits as concussions get more MLS scrutiny - The Denver Post https://www.denverpost.com/sports/ci_20770179/concussions-colorado-rapids-effects-mls-scrutiny?source=pkg#ixzz1wl4LexyW
Read The Denver Post's Terms of Use of its content: https://www.denverpost.com/termsofuse

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Wednesday, 04 April 2012 10:19

Stone Phillips' youth football concussion report

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Common sense has led many to believe that youth football players can't possibly sustain high-impacts like their adult counterparts. But veteran correspondent Stone Phillips' report "Hard Hits, Hard Numbers," featured researchers at Virginia Tech (VT) who recently turned that theory upside down when they analyzed impact data from the helmets of 7- and 8-year old players in Montgomery County, Virginia.

Accelerometers placed inside seven helmets wirelessly transmitted data to scientists on the sideline for a season's worth of practices and games, with surprising results. The bottom line? Maybe it's time to take another look at practices, drills, and helmet design to minimize the forces absorbed during an average season.

Regardless of the significance of the impact, none of the players sustained concussions during the season. Therein lies an enduring mystery, why small impacts cause concussions in some players while others walk away from big hits.

https://https://

The force of acceleration is often measured in g. Fighter pilots may "pull" 9g in an F-16, a sneeze may register 3g. They're part of everyday life. But because of the heightened interest in sports-related concussions, researchers are investigating a multitude of ways to reduce brain impacts for everyone from adults to youth. But first, they had to identify if there was even an issue at all.

Worth a look

The VT study was the first of its kind to measure the impacts sustained during youth football. Having worked for nine years recording over 150,000 hits with the helmet impact system at the university, researchers turned their attention to an area youth league.

The forces averaged about 15g, meaning half of the hits measured below that level, the other half above. In one case, well above. One hit measured 100g, a big hit by college standards. Most of the more forceful impacts came during practice.

Highlights from PBS NewsHour include:

- reseachers believe 98g or above is a red flag for a possible concussion

- a total 753 impacts were recorded

- average player sustained 107 impacts in one season; high school players average about 500; college players sustain about 1,000/season

- there were 38 impacts of 40g or greater; almost every one occurred during practice

- six impacts measured over 80g, the lower range VT researchers consider to be the risk of concussion

- youth football players lack strong neck and chest muscles of older players to maintain head stability

- 50, 60, 70g impacts were surprising

- location of impact is important as are individual differences and tolerances

- there is more helmet-to-helmet contact in youth football than occurs in older players; most impacts occurred on the front of helmet

- more head-to-ground impacts found at college level

Changes ahttps://trong>

Researchehttps://luded that addressing changes in practice would likely reduce the number of impacts per season, an important factor in any youth sport. Less contact drills, fewer contact practices and other modifications would be beneficial, particularly as the effects of sub-concussive hits, impacts that may cause changes in the brain without causing symptoms, continue to be studied.

Source: Stone Phillips Reports

Pint-Size Footbal Players Take Big-League Hits -- PBS NewsHour -- April 3, 2012

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Wednesday, 30 May 2012 15:38
First on-field soccer impact study

https://
Collisions. Headers. Goalpost run-ins. Soccer athletes and fans can't help but wonder which elements contribute most to the frequency of concussions in the sport, particularly among young girls. Researchers have been collecting data in helmeted sports for many years using accelerometers embedded in head gear, but non-helmeted sports have presented obvious challenges.

Impact data has provided some of the most critical science in the concussion field. As a result, the forces that players sustain in various contact sports are well-documented and found, in some cases, to be alarming. The latest addition to the data bank was the inclusion of an impact study on 7-and 8-year-old football players and the adult-sized forces they incurred during practices.

Now the focus is turning to other sports, including soccer. A new study by researchers at Wayne State University, published in the Journal of the American College of Sports Medicine offers insight into head acceleration in girls' youth soccer (U14) during game play.

HITS

The Head Impact Telemetry System (HITS) used to measure the force impacts, was utilized in this study. Small accelerometers typically mounted inside helmets, transmit data wirelessly to researchers on the sideline. In this case, soccer headbands with the padding removed were outfitted with the instrumentation. Impacts over 10g, or 10x the force of gravity, were recorded and analyzed at a later time alongside corresponding video footage to determine the nature of the hit. For reference, a sneeze might be 3g, a fighter pilot might "pull" 9g during maneuvers, and high school football players regularly sustain hits ranging from 60-100g and higher, many without reporting concussion symptoms.

A total of 24 girls participated in the study, conducted during scrimmages on grass fields. Scrimmages lasted 30 to 65 minutes each. None of the players suffered a concussion during the research.

Results

There were 47 header impacts and 20 non-header impacts observed during the study. Non-header impacts included collisions with another player, player falls, collisions with goalposts, and unintended collisions with the ball. Researchers found:

- majority of non-header impacts (40%) were player-to-player collisions

- most headers impacted the front of the head; the peak linear acceleration (force) recorded was 4.5g

- greatest header force occurred on the right side of the head and was measured at 62.9g

- most head impacts players sustained in one scrimmage was four

- side headers resulted in greater forces than back headers

- player collisions resulted in the highest number of nonheader impacts and had a maximum force of 56.7g

- impacts from player falls measured a maximum force of 23.7g

- a goalpost collision measured a maximum of 27.1g

Researchers hypothesized that non-header impacts would exceed those from heading the ball, but that was not what the case. Many of the players experienced multiple impacts in a single scrimmage, the cumulative effects of such impacts within a short time frame are unknown.

Conclusions

Concussions can occur in any spohttps://amending equipment and making rule changes to decrease the frequency and severity of the injury depends on science. Soccer has emerged as the leading cause of sport-related concussions for young girls and researchers are working to unravel the reasons why. Hypotheses range from less neck strength, to hormonal differences to better reporting by females.

Source:

Medicine & Science in Sports & Exercise: June 2012 - Volume 44 - Issue 6 - p 1102–1108 doi: 10.1249/MSS.0b013e3182444d7d Applied Sciences

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Wednesday, 23 May 2012 21:54
First responders: concussions no easy task

SEQUIM, Wash. -- Battle-tested and a little weary from last fall’s high school football season, Travis Anderson, an experienced EMT and paramedic John Riley, understand the nuances of concussions. Athletes who — if they are conscious – say they are ‘fine,’ coaches who may not be sure an athlete needs medical attention, and parents told by ER staff that rest is the prescription for recovery, trying to make sense of the mountain of hospital medical bills.

They’ve seen it all, and it’s not easy.

First responders like Anderson and Riley from Clallam County Fire District #3 in Sequim, Wash., are a luxury for school districts around the country. Part of a crew made up of paid staff and volunteers, they wait in the corners until given the signal by a coach or referee, or a player goes down and stays there.

Like other on-field personnel they can’t see every impact and don’t always know if an athlete is deteriorating on the bench after a big hit. They depend on an educated coaching staff and fellow teammates for their cues.

Anderson said,”We’d like to be called sooner rather than later. If there’s any question, especially with a suspected concussion, call us.”

Too little care

Only about 42 percent of high schools nationally employ athletic trainers, a dismal number in the eyes of many concussion experts who continue to advise against any school district or private organization offering contact sports without proper sideline medical care.

Given the budget crises facing many school districts, it is not surprising so few heed this advice.

But the challenges in rural areas are even greater. Long distances separate football fields from hospitals and fire stations can serve several high schools. Resources are simply too lean.

Many sports-related concussions

“Our fire department provides sideline staff for high school football games, and as many junior varsity games as we can. We consider it part of our community service effort and quite frankly, we feel strongly about protecting our student-athletes and their futures,” said District #3’s Fire Chief, Steve Vogel. His first responders have been on the sidelines at Sequim School District's games since 1982.

Chief Vogel’s staff has a long history dealing with sports concussions. Former Sequim football player Adrien Gault suffered a catastrophic brain injury during a game in 2006 and was airlifted to a Seattle trauma center where doctors gave him a four-percent chance of survival. He continues to work through his recovery.

This past fall, a Sequim student suffered a brain aneurysm during a Friday afternoon PE class and died a few days later. That same Friday there were six significant concussions on the football field a few hundred yards away, said a well-informed source, turning the field into a war zone.

Fire District #3 was there for it all. “There were more concussions during that one game than I’ve seen in my entire career, including my time as a running back in high school,” said Anderson. “It was a rarity.”

Neither he nor Riley, who played tight end in high school remember suffering concussions during their football careers. They believe they’re seeing so many due to increased awareness trickling down from the NFL. Anderson said, “I think the attention on the concussion issue in the NFL is having an affect on all levels of the game, all the way down to the youngest players.”

Emergency Medical Services for Children (EMSC)

Guidelines and training for first responders come in the form of online education modules and concussion-related drills practiced several times a year.

Soon-to-be-released state protocols developed by emergency room physicians, critical care nurses, EMTs, and others who make up the state committee of the federal Emergency Medical Services for Children program include a sports-concussion guide for first responders. Upon distribution, this document will provide a handy reference for those who attend youth and high school athletic events.

“The Emergency Medical Services for Children (EMSC) program works to ensure proper pediatric care is available on ambulances and in hospital emergency departments nationwide,” said Ian Weston, Co-Director of the EMSC program headquartered in suburban Wash. D.C. “Emergency care providers are integral in ensuring our children get the right care when it counts.”

When to call 911

Concussion symptoms can be subtle and may not appear right away, leaving room for mistakes to be made if athletes are not properly monitored when a concussion is suspected. The following are symptoms that require a call for emergency evaluation:

•headaches that worsen

•seizures

•neck pain

•very drowsy, can't be awakened

•repeated vomiting

•increasing confusion or irritability

•weakness, numbness in arms and legs

•unable to recognize people/places, less responsive than usual

For more information see Should we call 911?, signs and symptoms

Photo: (L) John Riley (firefighter/paramedic); (R) Travis Anderson (firefighter/EMT)

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Wednesday, 30 May 2012 00:00
After concussion laws, more safety measures

New scientific data and increased awareness regarding the potential for long-term effects from concussions have led to several proposals to reduce the number of injuries suffered by student-athletes in Washington State. Home of the Lystedt Law, Washington State's concussion law was passed in 2009 and adopted by NFL Commissioner Roger Goodell, who urged all governors to pass similar legislation. Thirty-six states have done so.

The next step in protecting athletes will likely come from the Washington Interscholastic Activities Association where a number of solutions are under consideration, some more popular than others.
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Limiting equipment use

This winter, Robert Polk, athletic director at Everett High School proposed an amendment to the WIAA that would severely limit the use of school-issued football helmets and shoulder pads during the summer. WIAA Amendment 6 would only allow this specialized equipment to be used during the designated school season and for summer all-state games, effectively curtailing contact summer camps or similar pre-season activity. It's purpose was to help reduce the number of hits sustained by football players.

The idea was not well accepted by coaches around the state, and hundreds signed a petition against it fearing unintended consequences.
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"In my opinion it's OK to take small steps and limit teams to attending only approved camps and limit spring contact to one week," said Lakewood head coach DanTeeter, who runs a passing camp during the summer that would become irrelevant if Amendment 6 passed. "But this amendment just goes too far."

The amendment was voted down by a large margin.
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"More and more studies are showing that the culmination of all of these hits are ending in brain trauma and lasting effects," Polk said. "I wanted to make sure we got the conversation going about kids safety," according to theHeraldnet.com.

More changes ahead

"Go out and play the beautiful game of football, but do it the right way and let's not beat these kids up," Bob Bourgette, president of the Washington State Football Coaches Association told King-5 news.

His organization is asking high school teams to cut the number of practice days from as many as 48, down to 20. Less practices, less contact, fewer concussions. The WSFCA position statement was submitted to the WIAA executive board at its April 15 meeting. The program is voluntary this year and Bourgette says he has received positive feedback from superintendents, principals, and athletic directors.

He is in good comhttps://Last summer, eight Ivy League presidents, two of whom are medical doctors, reduced the number of contact practices for their football teams allowing fewer per week than NCAA rules specify.

Thehttps://s also considering changes to kick-off rules moving the ball closer to the 50-yard line, in an effort to reduce high-impact collisions.

Source: Proposed limits on football practice, helmet use, sparks spirited outcry -- the Heraldnet.com -- Feb. 27, 2012

Concussion controversy could change rules for high school football -- King5 News -- May 11, 2012

Photo courtesy of (c)2008 I'll Never Grow Up@CreativeCommons

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